Differentiation is key in a clustered market like the Middle East. MED identifies niche services to boost your clinic’s profile and deliver maximum returns for minimum effort.
As dentistry in the Middle East becomes increasingly competitive, practitioners are seeking new ways to help their clinics stand out. As MED has reported elsewhere in this issue, disciplines like implantology, while prestigious, are not cheap in terms of cost and the investment of time required to master them.
However, there are a number of bolt-on services that will augment a clinic’s offerings with very little outlay from the practitioner. These niche services offer an opportunity to boost profits, without cutting the purse strings or clogging up the schedule.
To really add value to your practice you have to look at what has been tried and tested, as well as what is new in the market.
Those who can, bleach
Like all business decisions, supply and demand plays a lead role in the selection of niche services. “It is crucial for any dentist to understand their client base,” says Dr Jaco Smith, proprietor of The Dental Studio in Dubai.
“We have a number of questionnaires that we ask our clients to fill out so we can better understand what they want and what they don’t, as well as their likes and dislikes. We treat them according to that.”
When considering new services, he advises, it’s essential to evaluate whether they will enhance patient experience. “To really add value to your practice you have to look at what has been tried and tested, as well as what is new in the market.”
Not many people like visiting the dentist. It’s an unfortunate truth of the profession. By adding value to the experience, clinics give patients a reason to attend, which in turn improves treatment uptake and profit.
Cosmetic dentistry is a case in point. A number of dental clinics still fail to offer bleaching services, despite the procedure’s popularity. In the list of aesthetic treatments, bleaching is low-cost, low-risk and typically provides good returns.
“It’s a nice service to add because it is reversible, it is non-invasive, it is cheap and people want it,” shrugs Payman Langroudi, clinical director at bleaching firm Enlighten Smiles.
“There are not many things that a dentist does that will fulfil these criteria.”
Aside from being a service that sells itself, bleaching can offer returns of up to US$270 for a comparatively small outlay. Kits are cheap to purchase and, equally, training is easy to access.
Most whitening companies, including Enlighten, will provide training to dentists using their products. “We offer a one hour training session, which can be done online,” Langroudi explains. “We have found that dentists prefer this method, as it means less time out of the practice.”
Bleaching services can also provide a springboard to pricier cosmetic treatments. A 2006 survey conducted by the British Academy of Cosmetic Dentistry (BACD) showed that 31% of UK residents polled had undergone bleaching.
More than a quarter had received additional cosmetic dental treatments. In areas of the Middle East, such as Lebanon, where cosmetic services drive the industry, figures are likely to be even higher. Langroudi reports increased demand for Enlighten’s whitening products across the Gulf region, in particular the UAE, Bahrain and Lebanon.
“All cosmetic dentists are aware that whitening is the first thing that patients do, so it gets them on to the whole idea of changing their smile,” Langroudi explains.
“There are hard benefits and profits that dentists make from whitening. The amount that they can charge is quite high because patients will pay for cosmetic results.” Diamond whites
For patients that demonstrate an interest in cosmetic treatments, there are other small, non-invasive services that can be brought into the practice as low-cost smile enhancements.
While not to everyone’s taste, tooth jewellery is a case in point. The US-led trend of attaching small jewels to teeth has proved very popular among teenage girls and boys.
If you can find a natural alternative to common medication, it is a practice booster because people will talk about it.
Clearly, as Dr Smith warns, this service’s success will depend on the age of your patient base, but if it is judged correctly it can add to your bottom line.
Lotta Loberg, owner of Twindent, the company that manufactures Twinkles Tooth Jewellery, claims that in most cases, a practice can enjoy a $30 to $50 profit per bonding.
“It’s a very fast and inexpensive procedure and a dentist can easily reach big volumes because it is so popular among a broad spectrum of women,” she says.
“It can deliver a good profit to a clinic because the bonding of the jewel can be done by a dental assistant or hygienist. You don’t have to use the dentist’s time.
“It takes between five and 10 minutes of chair time, so it can easily be tagged onto a treatment if the patient is already in the chair.”
Because the jewellery is removable, dentists can levy a small charge to remove the jewel, as reversal needs to be completed by a professional.
A once niche industry that is increasingly becoming more mainstream is alternative medicine. Smith has earmarked this area of practice as a future trend for the dental industry. “You have to open your mind and look at natural products,” he argues.
“There are a lot of people out there that are allergic to penicillin and [other medication] so you have to have an alternative.”
Smith suggests exploring holistic medicines, such as natural toothpastes, gels and herbal remedies that can play a role in periodontal health. “One of the big things in that arena is manuka honey. It is effective and has a healing factor.”
Manuka honey hails from New Zealand and is farmed from bees that extract pollen from the country’s native manuka bush. Clinical tests have suggested the honey has active microbial healing properties. Smith believes there is a huge market for this kind of approach in the region and that patients will happily pay a premium for it.
“The honey could be used to treat people with gum disease who do not want to use medication,” he explains. “If you can find a natural alternative to common medication, it is a practice booster because people will talk about it. You are entering an under-serviced market and…word of mouth will spread the message.”
Another service that Smith rates as a practice booster is less holistic and more futuristic. “Definitely look at laser dentistry,” he says. “It is relatively inexpensive, and you can take away some of that fear factor…such as the sound of the drill.
“That kind of thing will bring more people to you through word of mouth.”
Light work
Recent drops in price have made lasers more affordable for general practices. While still the most expensive of the niche services featured so far, lasers are also likely to offer the most return for forward-looking clinics.
Dr Jonathan Bregman, a US-based dentist who has lectured widely on the benefits of laser dentistry, says the technology proved to be an immediate success at his North Carolina practice.
While the initial outlay of between $8,000 to $15,000 is steep, training is usually included in the price of the laser unit and the benefits will be evident very quickly.
“It is not difficult for a dentist to move up the learning curve with some haste,” Bregman explains. “It doesn’t take long to start doing basic procedures with lasers, and dentists will soon find it is quicker, and offers more predictable results, than traditional methods.”There are a number of ways in which a clinic can benefit from incorporating laser technology, he reports. Firstly, there is the efficiency of the technique.
Experienced laser dentists are able to shave up to 15 minutes off procedures that would normally take 45 minutes to complete. “Add this up over a number of procedures and you start thinking about the extra appointments you can add into the day,” Bregman notes.
Secondly, and as importantly, lasers offer more comfort for the patient. “It opened up the door for me to do many more procedures without an injected local anaesthetic,” Bregman advises, “and that is the happiest moment in a patient’s visit when you tell them there is no need for an injection.”
Ninety percent of the basic filling treatments Bregman performs now utilise the laser and no anaesthetic. “It has opened the door to greater patient acceptance of treatments when previously they were hesitant due to fear of the injection, the numb lip or the noise of the drill.”
Lasers also help in keeping treatments in-house, Procedures such as biopsies, frenectomies and soft tissue contouring can be retained by general practices and performed using topical anaesthetics. “Many procedures using laser have a much more predictable outcome and they are also fun,” Bregman notes.
“It adds a whole new dimension and level of excitement to routine dentistry.”
Niche to have
These therapies are available now, but waiting in the wings (and for government approval) are services that local dentists are itching to implement in their clinics. While lasers offer a certain amount of pain-free dentistry, a wide range of procedures still require an anaesthetic.
“That,” Dr Jaco Smith explains, “is where IV sedation comes in.” Unfortunately for Smith, in the UAE, the technique is only allowed to be administered at hospitals.
A lot of dental clinics in the UK and the US that use the technique employ terms such as ‘sleep dentistry’ when talking about IV sedation. The patient remains relaxed but conscious throughout the procedure and is able to understand and respond to requests from the dentist.
“Scared patients can have this instead of being knocked out with general anaesthetic in a hospital setting,” Smith insists.
I think there is a market for that here, especially with children. If IV sedation is done in a safe environment with enough regulation, it could prove to be a very big market here.
He is also an advocate of dentists being allowed to add wider cosmetic procedures to their clinic. “One thing we have been doing at our practice in England for a few years is incorporating Botox, derma-fillers and all of those facial aesthetic treatments,” he adds.
Smith believes dentists could be licensed to offer facial cosmetics with sufficient training. “In the UK, once they have received their license, dentists are accredited. In Dubai this is not allowed.”
As has been seen before, it’s likely the Middle East market will eventually follow the lead of the US and Europe. Until that time, however, dentists such as Dr Smith must play the waiting game and observe the development of such techniques from afar in order to be fully prepared when that time comes.
“These niche services are definitely potential money spinners and worth keeping an eye on,” Smith advises.
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